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Imtiaz A. Chaudhry, Saif S. Al-Obaisi, Ayman Al-Ayoubi; Chilhood Orbital Pseudotumor: Experience From A Tertiary Eye Care Center. Invest. Ophthalmol. Vis. Sci. 2011;52(14):717.
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Orbital pseudotumor, also known as idiopathic orbital inflammation, is a nonspecific, non-neoplastic inflammatory process of the orbit without identifiable local or systemic causes. The disorder is more prevalent in the adult population than in the pediatric population. While in the adult patients, diagnosis and management of orbital pseudotumor has been subject of constant debate, the evaluation and management of pediatric orbital pseudotumor is less discussed because of its rarity in this population. The purpose of this study is to describe clinical features and our experience in dealing with cases of orbital inflammatory disorders in children presenting to a tertiary eye care center.
Retrospective case series of pediatric patients diagnosed with orbital pseudotumor at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, a major tertiary eye care referral center in the Middle East, were reviewed for their presenting signs and symptoms, diagnostic studies and treatment outcomes.
There were 24 cases (16 female, 8 male) with average age of 9.8 years (range 1.5 to 16 years) at the time of presentation. Six patients (25%) had bilateral disease. Most common presenting signs and symptoms included, eyelid swelling in 22 (91.7%), proptosis in 20 (83.3%), pain in 18 (75%), upper eyelid ptosis in 15 (62.5%), decreased visual acuity in 12 (50%) and ocular motility disturbance in10 (41.7%) patients. Some of the other signs and symptoms included fever and leukocytosis in 10 (41.7%), tearing in 6 (25%) and headaches in 4 (20%) patients. All patients required imaging studies that included computed tomography scans and/or magnetic resonance imaging which revealed enlarged extraocular muscle in 21 (87.5%) and enlarged lacrimal glands in 13 (54.2%) patients. During the course of their care,18 (75%) patients were treated with systemic corticosteroirds and 10 (41.7%) patients were treated with systemic antibiotics. Orbital biopsies revealed evidence of non-specific granulatomtous inflammation. Average follow-up was 2.2 years (range 2 week to 9 years).
Orbital psuedotumor in children can be bilateral disease in significant number of cases and many of them may present with systemic findings. Majority of pediatric orbital pseudotumor patients may need treatment in the form of systemic corticosteroids and/or antibiotics.
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